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Encore PFO Closure Device - The PerFOrm Trial

E

Encore Medical

Status

Enrolling

Conditions

Cryptogenic Stroke
Patent Foramen Ovale

Treatments

Device: FDA-approved PFO closure device
Device: Encore PFO closure device

Study type

Interventional

Funder types

Other
Industry

Identifiers

NCT05537753
ENC-CL-5000

Details and patient eligibility

About

The objective of this study is to establish reasonable assurance of safety, effectiveness, and noninferiority of the Encore PFO closure device when compared to any investigator chosen FDA-approved PFO closure device.

Full description

This is a prospective, multicenter, randomized clinical study to determine the safety and effectiveness of the Encore PFO closure device, which is indicated for percutaneous, transcatheter closure of a patent foramen ovale (PFO) in patients who have had a cryptogenic stroke due to a presumed paradoxical embolism.

Enrollment

500 estimated patients

Sex

All

Ages

18 to 60 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  1. Diagnosis of PFO, defined as visualization of microbubbles per TEE in the left atrium within three cardiac cycles from the right atrial opacification demonstrating right-to-left shunting at rest and/or during Valsalva release
  2. Cryptogenic stroke within the last 270 days; stroke is defined as acute focal neurological deficit, presumed to be due to focal ischemia, and confirmed by MRI or CT to be a new, neuroanatomically relevant cerebral infarct

Exclusion criteria

  1. Age <18 years and age >60 years
  2. Greater than 50% lumen diameter stenosis of intracranial or extracranial vessels
  3. Intracardiac thrombus or tumor
  4. Acute or recent (within 6 months) myocardial infarction (MI) or unstable angina
  5. Left ventricular aneurysm or akinesis
  6. Mitral valve stenosis (mitral valve area less than 1.5cm2) or severe mitral regurgitation
  7. Aortic valve stenosis (gradient >40 mmHg) or severe aortic valve regurgitation
  8. Mitral or aortic valve vegetation or prosthesis
  9. Left ventricular ejection fraction <35%
  10. Other identifiable cause of stroke, including but not limited to aortic arch plaques (protruding >4 mm into the lumen), large artery atherosclerotic disease, an established cardioembolic source, small-vessel occlusive disease, or arterial dissection
  11. Evidence of a hypercoagulable disorder requiring anticoagulation therapy; this determination will be based on the evaluation of: anticardiolipin antibody (Ab) of the IgG or IgM type, Lupus anticoagulant, B2-glycoprotein-1 Ab, and fasting plasma homocysteine
  12. Another source of right-to-left shunts identified at baseline, including an atrial septal defect and/or fenestrated septum
  13. Any history of atrial fibrillation/atrial flutter (chronic or intermittent)
  14. Active endocarditis or other untreated infections
  15. Chronic kidney disease stage 4 or higher or end-stage renal failure requiring dialysis (eGFR less than 30)
  16. Severe liver disease (ALT 3X ULN) or documented cirrhosis
  17. Lung disease requiring continuous home oxygen
  18. Uncontrolled hypertension, defined as sustained elevated blood pressure >160/90 mm Hg on medication
  19. Uncontrolled diabetes mellitus, defined as HbA1c greater than 9 (based on most recent test which must have been collected within the last year)
  20. Anatomical or physiological structures that do not permit TEE
  21. Anticipated need for treatment of structural cardiac defects other than PFO
  22. Concomitant cardiac anomalies requiring an operative procedure
  23. Hemorrhagic diseases (e.g., coagulopathy, tendency to hemolysis)
  24. Hypersensitivity to contrast medium or nickel
  25. Contraindication to aspirin or clopidogrel
  26. The required sheaths cannot be passed through the relevant vessels for access to the PFO
  27. Vulnerable patient (e.g., incarcerated or cognitively challenged adults); see Section 7.2.1
  28. Subject is unable or unwilling to provide informed consent
  29. Subject is unable to comply with the protocol
  30. Any other clinical reasons for which the patient would not be an appropriate candidate for the study, as determined by the site investigators

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

500 participants in 2 patient groups

Encore PFO closure device
Experimental group
Treatment:
Device: Encore PFO closure device
Any FDA-approved PFO closure device chosen by the investigator
Active Comparator group
Treatment:
Device: FDA-approved PFO closure device

Trial contacts and locations

8

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Central trial contact

Joseph Marino; Hannah Bearinger

Data sourced from clinicaltrials.gov

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